Articles: bacteria.
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In 44 patients tracheotomized and under mechanical ventilation bacteriological studies were carried out, inmediately after death, in bronchial secretions and in a small piece of lung obtained by thoracotomy. The more frequently found bacterium in bronchial secretions or the lung was the Pseudomona aeruginosa (Table 1). In order of decreasing frequency: Klebsiella, Staphylococcus, Proteus, etc. were found in the lung while in bronchial secretions the order was inverse by predominance of Proteus. ⋯ Bacteria were different in 6 cases (Table 2) in 4 of them: staphylococcus was obtained in the lung while Pseudomonae, Proteus and Klebsiellae were present in bronchial secretions (Table 3). In 16 cases cultures of the piece of lung taken were negative. Not taking into account these last ones, it is possible to conclude that from the therapeutic stand point culture of bronchial secretions was useful in antibiotic selection in 22 out of 28 cases.
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There is a definite short period when the developing staphylococcal dermal or incisional infection may be suppressed by antibiotics. This effective period begins the moment bacteria gain access to the tissue is over in 3 hours. Systemic antibiotics have no effect on primary staphylococcal infections if the bacteria creating the infection have been in the tissue longer than 3 hours before the antibiotics are given. Antibiotics cause maximum suppression of infection if given before bacteria gan access to tissue.